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To that end, ordinary membership is open to those Nuclear Medicine professionals employed in a Nuclear\\nMedicine practice that satisfies any one of the following criteria: 1. Practice located in a centre that the Federal Government Rural, Regional and Metropolitan Area (RRMA) classification deems either rural or remote. 2. Practice located in a centre that is more than 200 km from the state capital. 3. Practice located in a centre that is more than 100 km from nearest other nuclear medicine practice.\u00a0\\nAssociate membership to RAINS is open to: 1. Students not actively employed in Nuclear Medicine who are undertaking undergraduate or post graduate studies in Nuclear Medicine at any Australian university and who come from a RRMA classified rural or remote centre. 2. Nuclear Medicine professionals employed in a Nuclear Medicine centre that does not meet the criteria for ordinary membership but who believe issues of professional isolation have a deleterious impact on professional development. Examples of such isolation include, but are not limited to; academics, researchers, company representatives and regional isolation with a small Nuclear Medicine network (e.g. Newcastle, Central Coast, Gold Coast).\u00a0\\nOrdinary membership entitlements include, but are not limited to: \u2022 Newsletter (electronic) \u2022 Networking (eg. research, problem solving, reduce professional isolation) \u2022 CPD activities (e-journal club, e-grand rounds, e-seminars etc) \u2022 Representation \u2022 Support \u2022 Full voting rights\u00a0\\nAssociate membership entitlements include, but are not limited to: \u2022 Newsletter (electronic) \u2022 Networking (eg. research, problem solving, reduce professional isolation) \u2022 CPD activities (e-journal club, e-grand rounds, e-seminars etc) \u2022 Representation \u2022 Support\",\"type\":\"control_text\"},{\"name\":\"clickTo4\",\"qid\":\"4\",\"text\":\"APPLICATION FOR MEMBERSHIP\",\"type\":\"control_head\"},{\"name\":\"doubleclickTo5\",\"qid\":\"5\",\"text\":\"There are no membership fees for RAINS.\\nI wish to apply for membership to RAINS and, if accepted as a member, I undertake to comply with the RAINS Charter.\u00a0\",\"type\":\"control_text\"},{\"name\":\"seeMembership\",\"qid\":\"6\",\"text\":\"See membership guidelines (please select):\",\"type\":\"control_checkbox\"},{\"name\":\"professionalCategory7\",\"qid\":\"7\",\"text\":\"Professional Category (please select):\",\"type\":\"control_checkbox\"},{\"name\":\"areYou8\",\"qid\":\"8\",\"text\":\"Are you a member of (please select):\",\"type\":\"control_checkbox\"},{\"name\":\"fullName9\",\"qid\":\"9\",\"text\":\"Full Name\",\"type\":\"control_fullname\"},{\"name\":\"businessAddress\",\"qid\":\"10\",\"text\":\"Business Address (out of teaching period address for student):\",\"type\":\"control_address\"},{\"name\":\"phoneNumber11\",\"qid\":\"11\",\"text\":\"Phone Number\",\"type\":\"control_phone\"},null,{\"name\":\"email13\",\"qid\":\"13\",\"text\":\"E-mail\",\"type\":\"control_email\"},{\"name\":\"iAgree14\",\"qid\":\"14\",\"text\":\"I agree to have my telephone number and email address included on the RAINS database  and circulated amongst RAINS members.\",\"type\":\"control_checkbox\"}]);}, 20); \n<\/script>\n<\/head>\n<body>\n<form class=\"jotform-form\" action=\"https:\/\/submit.jotform.co\/submit\/41048563404854\/\" method=\"post\" name=\"form_41048563404854\" id=\"41048563404854\" accept-charset=\"utf-8\">\n  <input type=\"hidden\" name=\"formID\" value=\"41048563404854\" \/>\n  <div class=\"form-all\">\n    <ul class=\"form-section page-section\">\n      <li class=\"form-line\" data-type=\"control_text\" id=\"id_3\">\n        <div id=\"cid_3\" class=\"form-input-wide\">\n          <div id=\"text_3\" class=\"form-html\" data-component=\"text\">\n            <p><strong>MEMBERSHIP APPLICATION<\/strong><\/p>\n            <p>All Nuclear Medicine professionals with shared needs and philosophies are encouraged to join.\u00a0<\/p>\n            <p>Ordinary membership to RAINS is open to those Nuclear Medicine professionals sharing the needs and philosophies characteristic of rural Australia; underpinned by &quot;professional, social and cultural isolation&quot;. To that end, ordinary membership is open to those Nuclear Medicine professionals employed in a Nuclear<\/p>\n            <p>Medicine practice that satisfies any one of the following criteria: <br \/>1. Practice located in a centre that the Federal Government Rural, Regional and Metropolitan Area (RRMA) classification deems either rural or remote. <br \/>2. Practice located in a centre that is more than 200 km from the state capital. <br \/>3. Practice located in a centre that is more than 100 km from nearest other nuclear medicine practice.\u00a0<\/p>\n            <p><br \/>Associate membership to RAINS is open to: <br \/>1. Students not actively employed in Nuclear Medicine who are undertaking undergraduate or post graduate studies in Nuclear Medicine at any Australian university and who come from a RRMA classified rural or remote centre. <br \/>2. Nuclear Medicine professionals employed in a Nuclear Medicine centre that does not meet the criteria for ordinary membership but who believe issues of professional isolation have a deleterious impact on professional development. Examples of such isolation include, but are not limited to; academics, researchers, company representatives and regional isolation with a small Nuclear Medicine network (e.g. Newcastle, Central Coast, Gold Coast).\u00a0<\/p>\n            <p>Ordinary membership entitlements include, but are not limited to: <br \/>\u2022 Newsletter (electronic) <br \/>\u2022 Networking (eg. research, problem solving, reduce professional isolation) <br \/>\u2022 CPD activities (e-journal club, e-grand rounds, e-seminars etc) <br \/>\u2022 Representation <br \/>\u2022 Support <br \/>\u2022 Full voting rights\u00a0<\/p>\n            <p>Associate membership entitlements include, but are not limited to: <br \/>\u2022 Newsletter (electronic) <br \/>\u2022 Networking (eg. research, problem solving, reduce professional isolation) <br \/>\u2022 CPD activities (e-journal club, e-grand rounds, e-seminars etc) <br \/>\u2022 Representation <br \/>\u2022 Support<\/p>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li id=\"cid_4\" class=\"form-input-wide\" data-type=\"control_head\">\n        <div class=\"form-header-group \">\n          <div class=\"header-text httal htvam\">\n            <h3 id=\"header_4\" class=\"form-header\" data-component=\"header\">\n              APPLICATION FOR MEMBERSHIP\n            <\/h3>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" data-type=\"control_text\" id=\"id_5\">\n        <div id=\"cid_5\" class=\"form-input-wide\">\n          <div id=\"text_5\" class=\"form-html\" data-component=\"text\">\n            <p>There are no membership fees for RAINS.<\/p>\n            <p>I wish to apply for membership to RAINS and, if accepted as a member, I undertake to comply with the RAINS Charter.\u00a0<\/p>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line form-line-column form-col-1\" data-type=\"control_checkbox\" id=\"id_6\">\n        <label class=\"form-label form-label-top\" id=\"label_6\" for=\"input_6_0\"> See membership guidelines (please select): <\/label>\n        <div id=\"cid_6\" class=\"form-input-wide\">\n          <div class=\"form-single-column\" data-component=\"checkbox\">\n            <span class=\"form-checkbox-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"checkbox\" class=\"form-checkbox\" id=\"input_6_0\" name=\"q6_seeMembership[]\" value=\"Ordinary member\" \/>\n              <label id=\"label_input_6_0\" for=\"input_6_0\"> Ordinary member <\/label>\n            <\/span>\n            <span class=\"form-checkbox-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"checkbox\" class=\"form-checkbox\" id=\"input_6_1\" name=\"q6_seeMembership[]\" value=\"Associate member\" \/>\n              <label id=\"label_input_6_1\" for=\"input_6_1\"> Associate member <\/label>\n            <\/span>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line form-line-column form-col-2\" data-type=\"control_checkbox\" id=\"id_7\">\n        <label class=\"form-label form-label-top\" id=\"label_7\" for=\"input_7_0\"> Professional Category (please select): <\/label>\n        <div id=\"cid_7\" class=\"form-input-wide\">\n          <div class=\"form-single-column\" data-component=\"checkbox\">\n            <span class=\"form-checkbox-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"checkbox\" class=\"form-checkbox\" id=\"input_7_0\" name=\"q7_professionalCategory7[]\" value=\"Technologist\/Scientist\" \/>\n              <label id=\"label_input_7_0\" for=\"input_7_0\"> Technologist\/Scientist <\/label>\n            <\/span>\n            <span class=\"form-checkbox-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"checkbox\" class=\"form-checkbox\" id=\"input_7_1\" name=\"q7_professionalCategory7[]\" value=\"Physicist\" \/>\n              <label id=\"label_input_7_1\" for=\"input_7_1\"> Physicist <\/label>\n            <\/span>\n            <span class=\"form-checkbox-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"checkbox\" class=\"form-checkbox\" id=\"input_7_2\" name=\"q7_professionalCategory7[]\" value=\"Nurse\" \/>\n              <label id=\"label_input_7_2\" for=\"input_7_2\"> Nurse <\/label>\n            <\/span>\n            <span class=\"form-checkbox-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"checkbox\" class=\"form-checkbox\" id=\"input_7_3\" name=\"q7_professionalCategory7[]\" value=\"Radiopharmacist\" \/>\n              <label id=\"label_input_7_3\" for=\"input_7_3\"> Radiopharmacist <\/label>\n            <\/span>\n            <span class=\"form-checkbox-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"checkbox\" class=\"form-checkbox\" id=\"input_7_4\" name=\"q7_professionalCategory7[]\" value=\"Physician\" \/>\n              <label id=\"label_input_7_4\" for=\"input_7_4\"> Physician <\/label>\n            <\/span>\n            <span class=\"form-checkbox-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"checkbox\" class=\"form-checkbox\" id=\"input_7_5\" name=\"q7_professionalCategory7[]\" value=\"Radiologist\" \/>\n              <label id=\"label_input_7_5\" for=\"input_7_5\"> Radiologist <\/label>\n            <\/span>\n            <span class=\"form-checkbox-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"checkbox\" class=\"form-checkbox\" id=\"input_7_6\" name=\"q7_professionalCategory7[]\" value=\"Registrar\" \/>\n              <label id=\"label_input_7_6\" for=\"input_7_6\"> Registrar <\/label>\n            <\/span>\n            <span class=\"form-checkbox-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"checkbox\" class=\"form-checkbox\" id=\"input_7_7\" name=\"q7_professionalCategory7[]\" value=\"Student Technologist\" \/>\n              <label id=\"label_input_7_7\" for=\"input_7_7\"> Student Technologist <\/label>\n            <\/span>\n            <span class=\"form-checkbox-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"checkbox\" class=\"form-checkbox\" id=\"input_7_8\" name=\"q7_professionalCategory7[]\" value=\"Other\" \/>\n              <label id=\"label_input_7_8\" for=\"input_7_8\"> Other <\/label>\n            <\/span>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line form-line-column form-col-3\" data-type=\"control_checkbox\" id=\"id_8\">\n        <label class=\"form-label form-label-top\" id=\"label_8\" for=\"input_8_0\"> Are you a member of (please select): <\/label>\n        <div id=\"cid_8\" class=\"form-input-wide\">\n          <div class=\"form-single-column\" data-component=\"checkbox\">\n            <span class=\"form-checkbox-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"checkbox\" class=\"form-checkbox\" id=\"input_8_0\" name=\"q8_areYou8[]\" value=\"ANZSNM\" \/>\n              <label id=\"label_input_8_0\" for=\"input_8_0\"> ANZSNM <\/label>\n            <\/span>\n            <span class=\"form-checkbox-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"checkbox\" class=\"form-checkbox\" id=\"input_8_1\" name=\"q8_areYou8[]\" value=\"AIR\" \/>\n              <label id=\"label_input_8_1\" for=\"input_8_1\"> AIR <\/label>\n            <\/span>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line jf-required\" data-type=\"control_fullname\" id=\"id_9\">\n        <label class=\"form-label form-label-left form-label-auto\" id=\"label_9\" for=\"prefix_9\">\n          Full Name\n          <span class=\"form-required\">\n            *\n          <\/span>\n        <\/label>\n        <div id=\"cid_9\" class=\"form-input jf-required\">\n          <div data-wrapper-react=\"true\">\n            <span class=\"form-sub-label-container\" style=\"vertical-align:top;\">\n              <input type=\"text\" id=\"prefix_9\" name=\"q9_fullName9[prefix]\" class=\"form-textbox\" size=\"4\" value=\"\" data-component=\"prefix\" required=\"\" \/>\n              <label class=\"form-sub-label\" for=\"prefix_9\" id=\"sublabel_prefix\" style=\"min-height:13px;\"> Title <\/label>\n            <\/span>\n            <span class=\"form-sub-label-container\" style=\"vertical-align:top;\">\n              <input type=\"text\" id=\"first_9\" name=\"q9_fullName9[first]\" class=\"form-textbox validate[required]\" size=\"10\" value=\"\" data-component=\"first\" required=\"\" \/>\n              <label class=\"form-sub-label\" for=\"first_9\" id=\"sublabel_first\" style=\"min-height:13px;\"> First Name <\/label>\n            <\/span>\n            <span class=\"form-sub-label-container\" style=\"vertical-align:top;\">\n              <input type=\"text\" id=\"last_9\" name=\"q9_fullName9[last]\" class=\"form-textbox validate[required]\" size=\"15\" value=\"\" data-component=\"last\" required=\"\" \/>\n              <label class=\"form-sub-label\" for=\"last_9\" id=\"sublabel_last\" style=\"min-height:13px;\"> Last Name <\/label>\n            <\/span>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" data-type=\"control_address\" id=\"id_10\">\n        <label class=\"form-label form-label-left form-label-auto\" id=\"label_10\" for=\"input_10_addr_line1\"> Business Address (out of teaching period address for student): <\/label>\n        <div id=\"cid_10\" class=\"form-input\">\n          <table summary=\"\" class=\"form-address-table\" cellpadding=\"0\" cellspacing=\"0\">\n            <tbody>\n              <tr>\n                <td colspan=\"2\">\n                  <span class=\"form-sub-label-container\" style=\"vertical-align:top;\">\n                    <input type=\"text\" id=\"input_10_addr_line1\" name=\"q10_businessAddress[addr_line1]\" class=\"form-textbox form-address-line\" value=\"\" data-component=\"address_line_1\" \/>\n                    <label class=\"form-sub-label\" for=\"input_10_addr_line1\" id=\"sublabel_10_addr_line1\" style=\"min-height:13px;\"> Street Address <\/label>\n                  <\/span>\n                <\/td>\n              <\/tr>\n              <tr>\n                <td colspan=\"2\">\n                  <span class=\"form-sub-label-container\" style=\"vertical-align:top;\">\n                    <input type=\"text\" id=\"input_10_addr_line2\" name=\"q10_businessAddress[addr_line2]\" class=\"form-textbox form-address-line\" size=\"46\" value=\"\" data-component=\"address_line_2\" \/>\n                    <label class=\"form-sub-label\" for=\"input_10_addr_line2\" id=\"sublabel_10_addr_line2\" style=\"min-height:13px;\"> Street Address Line 2 <\/label>\n                  <\/span>\n                <\/td>\n              <\/tr>\n              <tr>\n                <td width=\"50%\">\n                  <span class=\"form-sub-label-container\" style=\"vertical-align:top;\">\n                    <input type=\"text\" id=\"input_10_city\" name=\"q10_businessAddress[city]\" class=\"form-textbox form-address-city\" size=\"21\" value=\"\" data-component=\"city\" \/>\n                    <label class=\"form-sub-label\" for=\"input_10_city\" id=\"sublabel_10_city\" style=\"min-height:13px;\"> City <\/label>\n                  <\/span>\n                <\/td>\n                <td>\n                  <span class=\"form-sub-label-container\" style=\"vertical-align:top;\">\n                    <input type=\"text\" id=\"input_10_state\" name=\"q10_businessAddress[state]\" class=\"form-textbox form-address-state\" size=\"22\" value=\"\" data-component=\"state\" \/>\n                    <label class=\"form-sub-label\" for=\"input_10_state\" id=\"sublabel_10_state\" style=\"min-height:13px;\"> State \/ Province <\/label>\n                  <\/span>\n                <\/td>\n              <\/tr>\n              <tr>\n                <td width=\"50%\">\n                  <span class=\"form-sub-label-container\" style=\"vertical-align:top;\">\n                    <input type=\"text\" id=\"input_10_postal\" name=\"q10_businessAddress[postal]\" class=\"form-textbox form-address-postal\" size=\"10\" value=\"\" data-component=\"zip\" \/>\n                    <label class=\"form-sub-label\" for=\"input_10_postal\" id=\"sublabel_10_postal\" style=\"min-height:13px;\"> Postal \/ Zip Code <\/label>\n                  <\/span>\n                <\/td>\n                <td>\n                  <span class=\"form-sub-label-container\" style=\"vertical-align:top;\">\n                    <select class=\"form-dropdown form-address-country\" name=\"q10_businessAddress[country]\" id=\"input_10_country\" data-component=\"country\">\n                      <option value=\"\"> Please Select <\/option>\n                      <option value=\"United States\"> United States <\/option>\n                      <option value=\"Afghanistan\"> Afghanistan <\/option>\n                      <option value=\"Albania\"> Albania <\/option>\n                      <option value=\"Algeria\"> Algeria <\/option>\n                      <option value=\"American Samoa\"> American Samoa <\/option>\n                      <option value=\"Andorra\"> Andorra <\/option>\n                      <option value=\"Angola\"> Angola <\/option>\n                      <option value=\"Anguilla\"> Anguilla <\/option>\n                      <option value=\"Antigua and Barbuda\"> Antigua and Barbuda <\/option>\n                      <option value=\"Argentina\"> Argentina <\/option>\n                      <option value=\"Armenia\"> Armenia <\/option>\n                      <option value=\"Aruba\"> Aruba <\/option>\n                      <option value=\"Australia\"> Australia <\/option>\n                      <option value=\"Austria\"> Austria <\/option>\n                      <option value=\"Azerbaijan\"> Azerbaijan <\/option>\n                      <option value=\"The Bahamas\"> The Bahamas <\/option>\n                      <option value=\"Bahrain\"> Bahrain <\/option>\n                      <option value=\"Bangladesh\"> Bangladesh <\/option>\n                      <option value=\"Barbados\"> Barbados <\/option>\n                      <option value=\"Belarus\"> Belarus <\/option>\n                      <option value=\"Belgium\"> Belgium <\/option>\n                      <option value=\"Belize\"> Belize <\/option>\n                      <option value=\"Benin\"> Benin <\/option>\n                      <option value=\"Bermuda\"> Bermuda <\/option>\n                      <option value=\"Bhutan\"> Bhutan <\/option>\n                      <option value=\"Bolivia\"> Bolivia <\/option>\n                      <option value=\"Bosnia and Herzegovina\"> Bosnia and Herzegovina <\/option>\n                      <option value=\"Botswana\"> Botswana <\/option>\n                      <option value=\"Brazil\"> Brazil <\/option>\n                      <option value=\"Brunei\"> Brunei <\/option>\n                      <option value=\"Bulgaria\"> Bulgaria <\/option>\n                      <option value=\"Burkina Faso\"> Burkina Faso <\/option>\n                      <option value=\"Burundi\"> Burundi <\/option>\n                      <option value=\"Cambodia\"> Cambodia <\/option>\n                      <option value=\"Cameroon\"> Cameroon <\/option>\n                      <option value=\"Canada\"> Canada <\/option>\n                      <option value=\"Cape Verde\"> Cape Verde <\/option>\n                      <option value=\"Cayman Islands\"> Cayman Islands <\/option>\n                      <option value=\"Central African Republic\"> Central African Republic <\/option>\n                      <option value=\"Chad\"> Chad <\/option>\n                      <option value=\"Chile\"> Chile <\/option>\n                      <option value=\"China\"> China <\/option>\n                      <option value=\"Christmas Island\"> Christmas Island <\/option>\n                      <option value=\"Cocos (Keeling) Islands\"> Cocos (Keeling) Islands <\/option>\n                      <option value=\"Colombia\"> Colombia <\/option>\n                      <option value=\"Comoros\"> Comoros <\/option>\n                      <option value=\"Congo\"> Congo <\/option>\n                      <option value=\"Cook Islands\"> Cook Islands <\/option>\n                      <option value=\"Costa Rica\"> Costa Rica <\/option>\n                      <option value=\"Cote d&#x27;Ivoire\"> Cote d&#x27;Ivoire <\/option>\n                      <option value=\"Croatia\"> Croatia <\/option>\n                      <option value=\"Cuba\"> Cuba <\/option>\n                      <option value=\"Cyprus\"> Cyprus <\/option>\n                      <option value=\"Czech Republic\"> Czech Republic <\/option>\n                      <option value=\"Democratic Republic of the Congo\"> Democratic Republic of the Congo <\/option>\n                      <option value=\"Denmark\"> Denmark <\/option>\n                      <option value=\"Djibouti\"> Djibouti <\/option>\n                      <option value=\"Dominica\"> Dominica <\/option>\n                      <option value=\"Dominican Republic\"> Dominican Republic <\/option>\n                      <option value=\"Ecuador\"> Ecuador <\/option>\n                      <option value=\"Egypt\"> Egypt <\/option>\n                      <option value=\"El Salvador\"> El Salvador <\/option>\n                      <option value=\"Equatorial Guinea\"> Equatorial Guinea <\/option>\n                      <option value=\"Eritrea\"> Eritrea <\/option>\n                      <option value=\"Estonia\"> Estonia <\/option>\n                      <option value=\"Ethiopia\"> Ethiopia <\/option>\n                      <option value=\"Falkland Islands\"> Falkland Islands <\/option>\n                      <option value=\"Faroe Islands\"> Faroe Islands <\/option>\n                      <option value=\"Fiji\"> Fiji <\/option>\n                      <option value=\"Finland\"> Finland <\/option>\n                      <option value=\"France\"> France <\/option>\n                      <option value=\"French Polynesia\"> French Polynesia <\/option>\n                      <option value=\"Gabon\"> Gabon <\/option>\n                      <option value=\"The Gambia\"> The Gambia <\/option>\n                      <option value=\"Georgia\"> Georgia <\/option>\n                      <option value=\"Germany\"> Germany <\/option>\n                      <option value=\"Ghana\"> Ghana <\/option>\n                      <option value=\"Gibraltar\"> Gibraltar <\/option>\n                      <option value=\"Greece\"> Greece <\/option>\n                      <option value=\"Greenland\"> Greenland <\/option>\n                      <option value=\"Grenada\"> Grenada <\/option>\n                      <option value=\"Guadeloupe\"> Guadeloupe <\/option>\n                      <option value=\"Guam\"> Guam <\/option>\n                      <option value=\"Guatemala\"> Guatemala <\/option>\n                      <option value=\"Guernsey\"> Guernsey <\/option>\n                      <option value=\"Guinea\"> Guinea <\/option>\n                      <option value=\"Guinea-Bissau\"> Guinea-Bissau <\/option>\n                      <option value=\"Guyana\"> Guyana <\/option>\n                      <option value=\"Haiti\"> Haiti <\/option>\n                      <option value=\"Honduras\"> Honduras <\/option>\n                      <option value=\"Hong Kong\"> Hong Kong <\/option>\n                      <option value=\"Hungary\"> Hungary <\/option>\n                      <option value=\"Iceland\"> Iceland <\/option>\n                      <option value=\"India\"> India <\/option>\n                      <option value=\"Indonesia\"> Indonesia <\/option>\n                      <option value=\"Iran\"> Iran <\/option>\n                      <option value=\"Iraq\"> Iraq <\/option>\n                      <option value=\"Ireland\"> Ireland <\/option>\n                      <option value=\"Israel\"> Israel <\/option>\n                      <option value=\"Italy\"> Italy <\/option>\n                      <option value=\"Jamaica\"> Jamaica <\/option>\n                      <option value=\"Japan\"> Japan <\/option>\n                      <option value=\"Jersey\"> Jersey <\/option>\n                      <option value=\"Jordan\"> Jordan <\/option>\n                      <option value=\"Kazakhstan\"> Kazakhstan <\/option>\n                      <option value=\"Kenya\"> Kenya <\/option>\n                      <option value=\"Kiribati\"> Kiribati <\/option>\n                      <option value=\"North Korea\"> North Korea <\/option>\n                      <option value=\"South Korea\"> South Korea <\/option>\n                      <option value=\"Kosovo\"> Kosovo <\/option>\n                      <option value=\"Kuwait\"> Kuwait <\/option>\n                      <option value=\"Kyrgyzstan\"> Kyrgyzstan <\/option>\n                      <option value=\"Laos\"> Laos <\/option>\n                      <option value=\"Latvia\"> Latvia <\/option>\n                      <option value=\"Lebanon\"> Lebanon <\/option>\n                      <option value=\"Lesotho\"> Lesotho <\/option>\n                      <option value=\"Liberia\"> Liberia <\/option>\n                      <option value=\"Libya\"> Libya <\/option>\n                      <option value=\"Liechtenstein\"> Liechtenstein <\/option>\n                      <option value=\"Lithuania\"> Lithuania <\/option>\n                      <option value=\"Luxembourg\"> Luxembourg <\/option>\n                      <option value=\"Macau\"> Macau <\/option>\n                      <option value=\"Macedonia\"> Macedonia <\/option>\n                      <option value=\"Madagascar\"> Madagascar <\/option>\n                      <option value=\"Malawi\"> Malawi <\/option>\n                      <option value=\"Malaysia\"> Malaysia <\/option>\n                      <option value=\"Maldives\"> Maldives <\/option>\n                      <option value=\"Mali\"> Mali <\/option>\n                      <option value=\"Malta\"> Malta <\/option>\n                      <option value=\"Marshall Islands\"> Marshall Islands <\/option>\n                      <option value=\"Martinique\"> Martinique <\/option>\n                      <option value=\"Mauritania\"> Mauritania <\/option>\n                      <option value=\"Mauritius\"> Mauritius <\/option>\n                      <option value=\"Mayotte\"> Mayotte <\/option>\n                      <option value=\"Mexico\"> Mexico <\/option>\n                      <option value=\"Micronesia\"> Micronesia <\/option>\n                      <option value=\"Moldova\"> Moldova <\/option>\n                      <option value=\"Monaco\"> Monaco <\/option>\n                      <option value=\"Mongolia\"> Mongolia <\/option>\n                      <option value=\"Montenegro\"> Montenegro <\/option>\n                      <option value=\"Montserrat\"> Montserrat <\/option>\n                      <option value=\"Morocco\"> Morocco <\/option>\n                      <option value=\"Mozambique\"> Mozambique <\/option>\n                      <option value=\"Myanmar\"> Myanmar <\/option>\n                      <option value=\"Nagorno-Karabakh\"> Nagorno-Karabakh <\/option>\n                      <option value=\"Namibia\"> Namibia <\/option>\n                      <option value=\"Nauru\"> Nauru <\/option>\n                      <option value=\"Nepal\"> Nepal <\/option>\n                      <option value=\"Netherlands\"> Netherlands <\/option>\n                      <option value=\"Netherlands Antilles\"> Netherlands Antilles <\/option>\n                      <option value=\"New Caledonia\"> New Caledonia <\/option>\n                      <option value=\"New Zealand\"> New Zealand <\/option>\n                      <option value=\"Nicaragua\"> Nicaragua <\/option>\n                      <option value=\"Niger\"> Niger <\/option>\n                      <option value=\"Nigeria\"> Nigeria <\/option>\n                      <option value=\"Niue\"> Niue <\/option>\n                      <option value=\"Norfolk Island\"> Norfolk Island <\/option>\n                      <option value=\"Turkish Republic of Northern Cyprus\"> Turkish Republic of Northern Cyprus <\/option>\n                      <option value=\"Northern Mariana\"> Northern Mariana <\/option>\n                      <option value=\"Norway\"> Norway <\/option>\n                      <option value=\"Oman\"> Oman <\/option>\n                      <option value=\"Pakistan\"> Pakistan <\/option>\n                      <option value=\"Palau\"> Palau <\/option>\n                      <option value=\"Palestine\"> Palestine <\/option>\n                      <option value=\"Panama\"> Panama <\/option>\n                      <option value=\"Papua New Guinea\"> Papua New Guinea <\/option>\n                      <option value=\"Paraguay\"> Paraguay <\/option>\n                      <option value=\"Peru\"> Peru <\/option>\n                      <option value=\"Philippines\"> Philippines <\/option>\n                      <option value=\"Pitcairn Islands\"> Pitcairn Islands <\/option>\n                      <option value=\"Poland\"> Poland <\/option>\n                      <option value=\"Portugal\"> Portugal <\/option>\n                      <option value=\"Puerto Rico\"> Puerto Rico <\/option>\n                      <option value=\"Qatar\"> Qatar <\/option>\n                      <option value=\"Republic of the Congo\"> Republic of the Congo <\/option>\n                      <option value=\"Romania\"> Romania <\/option>\n                      <option value=\"Russia\"> Russia <\/option>\n                      <option value=\"Rwanda\"> Rwanda <\/option>\n                      <option value=\"Saint Barthelemy\"> Saint Barthelemy <\/option>\n                      <option value=\"Saint Helena\"> Saint Helena <\/option>\n                      <option value=\"Saint Kitts and Nevis\"> Saint Kitts and Nevis <\/option>\n                      <option value=\"Saint Lucia\"> Saint Lucia <\/option>\n                      <option value=\"Saint Martin\"> Saint Martin <\/option>\n                      <option value=\"Saint Pierre and Miquelon\"> Saint Pierre and Miquelon <\/option>\n                      <option value=\"Saint Vincent and the Grenadines\"> Saint Vincent and the Grenadines <\/option>\n                      <option value=\"Samoa\"> Samoa <\/option>\n                      <option value=\"San Marino\"> San Marino <\/option>\n                      <option value=\"Sao Tome and Principe\"> Sao Tome and Principe <\/option>\n                      <option value=\"Saudi Arabia\"> Saudi Arabia <\/option>\n                      <option value=\"Senegal\"> Senegal <\/option>\n                      <option value=\"Serbia\"> Serbia <\/option>\n                      <option value=\"Seychelles\"> Seychelles <\/option>\n                      <option value=\"Sierra Leone\"> Sierra Leone <\/option>\n                      <option value=\"Singapore\"> Singapore <\/option>\n                      <option value=\"Slovakia\"> Slovakia <\/option>\n                      <option value=\"Slovenia\"> Slovenia <\/option>\n                      <option value=\"Solomon Islands\"> Solomon Islands <\/option>\n                      <option value=\"Somalia\"> Somalia <\/option>\n                      <option value=\"Somaliland\"> Somaliland <\/option>\n                      <option value=\"South Africa\"> South Africa <\/option>\n                      <option value=\"South Ossetia\"> South Ossetia <\/option>\n                      <option value=\"South Sudan\"> South Sudan <\/option>\n                      <option value=\"Spain\"> Spain <\/option>\n                      <option value=\"Sri Lanka\"> Sri Lanka <\/option>\n                      <option value=\"Sudan\"> Sudan <\/option>\n                      <option value=\"Suriname\"> Suriname <\/option>\n                      <option value=\"Svalbard\"> Svalbard <\/option>\n                      <option value=\"Swaziland\"> Swaziland <\/option>\n                      <option value=\"Sweden\"> Sweden <\/option>\n                      <option value=\"Switzerland\"> Switzerland <\/option>\n                      <option value=\"Syria\"> Syria <\/option>\n                      <option value=\"Taiwan\"> Taiwan <\/option>\n                      <option value=\"Tajikistan\"> Tajikistan <\/option>\n                      <option value=\"Tanzania\"> Tanzania <\/option>\n                      <option value=\"Thailand\"> Thailand <\/option>\n                      <option value=\"Timor-Leste\"> Timor-Leste <\/option>\n                      <option value=\"Togo\"> Togo <\/option>\n                      <option value=\"Tokelau\"> Tokelau <\/option>\n                      <option value=\"Tonga\"> Tonga <\/option>\n                      <option value=\"Transnistria Pridnestrovie\"> Transnistria Pridnestrovie <\/option>\n                      <option value=\"Trinidad and Tobago\"> Trinidad and Tobago <\/option>\n                      <option value=\"Tristan da Cunha\"> Tristan da Cunha <\/option>\n                      <option value=\"Tunisia\"> Tunisia <\/option>\n                      <option value=\"Turkey\"> Turkey <\/option>\n                      <option value=\"Turkmenistan\"> Turkmenistan <\/option>\n                      <option value=\"Turks and Caicos Islands\"> Turks and Caicos Islands <\/option>\n                      <option value=\"Tuvalu\"> Tuvalu <\/option>\n                      <option value=\"Uganda\"> Uganda <\/option>\n                      <option value=\"Ukraine\"> Ukraine <\/option>\n                      <option value=\"United Arab Emirates\"> United Arab Emirates <\/option>\n                      <option value=\"United Kingdom\"> United Kingdom <\/option>\n                      <option value=\"Uruguay\"> Uruguay <\/option>\n                      <option value=\"Uzbekistan\"> Uzbekistan <\/option>\n                      <option value=\"Vanuatu\"> Vanuatu <\/option>\n                      <option value=\"Vatican City\"> Vatican City <\/option>\n                      <option value=\"Venezuela\"> Venezuela <\/option>\n                      <option value=\"Vietnam\"> Vietnam <\/option>\n                      <option value=\"British Virgin Islands\"> British Virgin Islands <\/option>\n                      <option value=\"Isle of Man\"> Isle of Man <\/option>\n                      <option value=\"US Virgin Islands\"> US Virgin Islands <\/option>\n                      <option value=\"Wallis and Futuna\"> Wallis and Futuna <\/option>\n                      <option value=\"Western Sahara\"> Western Sahara <\/option>\n                      <option value=\"Yemen\"> Yemen <\/option>\n                      <option value=\"Zambia\"> Zambia <\/option>\n                      <option value=\"Zimbabwe\"> Zimbabwe <\/option>\n                      <option value=\"other\"> Other <\/option>\n                    <\/select>\n                    <label class=\"form-sub-label\" for=\"input_10_country\" id=\"sublabel_10_country\" style=\"min-height:13px;\"> Country <\/label>\n                  <\/span>\n                <\/td>\n              <\/tr>\n            <\/tbody>\n          <\/table>\n        <\/div>\n      <\/li>\n      <li class=\"form-line jf-required\" data-type=\"control_phone\" id=\"id_11\">\n        <label class=\"form-label form-label-left form-label-auto\" id=\"label_11\" for=\"input_11_area\">\n          Phone Number\n          <span class=\"form-required\">\n            *\n          <\/span>\n        <\/label>\n        <div id=\"cid_11\" class=\"form-input jf-required\">\n          <div data-wrapper-react=\"true\">\n            <span class=\"form-sub-label-container\" style=\"vertical-align:top;\">\n              <input type=\"tel\" id=\"input_11_area\" name=\"q11_phoneNumber11[area]\" class=\"form-textbox validate[required]\" size=\"3\" value=\"\" data-component=\"areaCode\" required=\"\" \/>\n              <span class=\"phone-separate\">\n                \u00a0-\n              <\/span>\n              <label class=\"form-sub-label\" for=\"input_11_area\" id=\"sublabel_area\" style=\"min-height:13px;\"> Area Code <\/label>\n            <\/span>\n            <span class=\"form-sub-label-container\" style=\"vertical-align:top;\">\n              <input type=\"tel\" id=\"input_11_phone\" name=\"q11_phoneNumber11[phone]\" class=\"form-textbox validate[required]\" size=\"8\" value=\"\" data-component=\"phone\" required=\"\" \/>\n              <label class=\"form-sub-label\" for=\"input_11_phone\" id=\"sublabel_phone\" style=\"min-height:13px;\"> Phone Number <\/label>\n            <\/span>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line jf-required\" data-type=\"control_email\" id=\"id_13\">\n        <label class=\"form-label form-label-left form-label-auto\" id=\"label_13\" for=\"input_13\">\n          E-mail\n          <span class=\"form-required\">\n            *\n          <\/span>\n        <\/label>\n        <div id=\"cid_13\" class=\"form-input jf-required\">\n          <input type=\"email\" id=\"input_13\" name=\"q13_email13\" class=\"form-textbox validate[required, Email]\" size=\"30\" value=\"\" placeholder=\"ex: myname@example.com\" data-component=\"email\" required=\"\" \/>\n        <\/div>\n      <\/li>\n      <li class=\"form-line form-line-column form-col-1 jf-required\" data-type=\"control_checkbox\" id=\"id_14\">\n        <label class=\"form-label form-label-top\" id=\"label_14\" for=\"input_14_0\">\n          I agree to have my telephone number and email address included on the RAINS database and circulated amongst RAINS members.\n          <span class=\"form-required\">\n            *\n          <\/span>\n        <\/label>\n        <div id=\"cid_14\" class=\"form-input-wide jf-required\">\n          <div class=\"form-single-column\" data-component=\"checkbox\">\n            <span class=\"form-checkbox-item\" style=\"clear:left;\">\n              <span class=\"dragger-item\">\n              <\/span>\n              <input type=\"checkbox\" class=\"form-checkbox validate[required]\" id=\"input_14_0\" name=\"q14_iAgree14[]\" value=\"Yes\" required=\"\" \/>\n              <label id=\"label_input_14_0\" for=\"input_14_0\"> Yes <\/label>\n            <\/span>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li class=\"form-line\" data-type=\"control_button\" id=\"id_2\">\n        <div id=\"cid_2\" class=\"form-input-wide\">\n          <div style=\"margin-left:156px;\" class=\"form-buttons-wrapper\">\n            <button id=\"input_2\" type=\"submit\" class=\"form-submit-button\" data-component=\"button\">\n              Submit Application\n            <\/button>\n          <\/div>\n        <\/div>\n      <\/li>\n      <li style=\"display:none\">\n        Should be Empty:\n        <input type=\"text\" name=\"website\" value=\"\" \/>\n      <\/li>\n    <\/ul>\n  <\/div>\n  <script>\n  JotForm.showJotFormPowered = \"0\";\n  <\/script>\n  <input type=\"hidden\" id=\"simple_spc\" name=\"simple_spc\" value=\"41048563404854\" \/>\n  <script type=\"text\/javascript\">\n  document.getElementById(\"si\" + \"mple\" + \"_spc\").value = \"41048563404854-41048563404854\";\n  <\/script>\n<\/form><\/body>\n<\/html>\n","Rural Alliance In Nuclear Scintigraphy - (RAINS) ",Array,0);(function(){window.handleIFrameMessage=function(e){if(!e.data||!e.data.split)return;var args=e.data.split(":");var iframe=document.getElementById("41048563404854");if(!iframe){return};switch(args[0]){case"scrollIntoView":if(!("nojump"in FrameBuilder.get)){iframe.scrollIntoView();}
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